30 years old patient with severe congenital deformation of the leg.
Patient was asked to go up the stairs backwards. This exercise requires a higher use of the quads, glutes and hamstrings than when climbing forward.
When climbing forward, we shift our center of mass forward, above the next step. When climbing backwards this is not possible, thereby the quads, glutes, hamstrings and gastrocnemius must work harder to move the body upwards. This also requires higher coordination, movement planning and balance.
The patient needs to be reminded to move his hands backwards, so that the center of mass will be as backwards as possible. When he needs to stand on his weak leg, he takes most of the weight off by using his hands.
Because the patient knows he cannot trust his right leg, he does not even pay attention to where he places it on the stairs. He only steps with half of his foot on the first stair and only stands on his toes on the final stair.
Video Guide 21